• Title/Summary/Keyword: General practitioner

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Comparative Evaluation of Drug Use for Outpatients Prescribed by General Practitioner and Specialized Practitioner in ENT Area (이비인후과 영역에서 일반의와 전문의에 의한 외래처방전의 비교 평가)

  • Min, Hyun-Seong;Song, Tae-Beom;Lee, Myung-Koo;Jang, Je-Kwan;Lee, Chong-Kil;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.258-269
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    • 2010
  • As people are easy to access the National Health Insurance, medical health service has been increased. It contributed to extend human's average life expectancy and to get better health care. But also increased unnecessary health service or inappropriate drug use. Therefore, DUR (Drug Use Review) is needed to induce appropriate drug use. The purpose of this study is to evaluate outpatient prescriptions by General Practitioner (GP) and Specialized Practitioner, especially indication for ENT referral including common cold which is the frequent indications that have patient see doctor. This study was reviewed retrospectively prescriptions for ENT referral collected at the A pharmacy for ENT Clinic in Cheong-Ju, B pharmacy for GP Clinic in BoEun from Feb 2nd, 2009 to Feb 28th, 2009. Each pharmacy located closed to the each enrolled clinic. The numbers of collected prescriptions were each A pharmacy (n=2501), B pharmacy (n=1343). This study was classified Drug Related Problems (DRPs) those prescriptions had as total 6 groups according to following 6 categories; 1) Unnecessary Drug, 2) Wrong Drug, 3) Low Dose, 4) Overdose, 5) Wrong Instruction, 6) Wrong Combination. In results, Specialized Practitioner's prescriptions had more DRPs than General Practitioner's prescriptions (ENT 155.34% vs GP 130.01%). In detail, Specialized Practitioner's prescriptions had more DRPs in Low Dose (ENT 16.95% vs GP 4.77%), Overdose (ENT 6.72% vs G.P 5.51%), Wrong Instruction (ENT 7.91% vs GP 5.81%), Wrong Combination (ENT 29.31% vs GP 25.09%). These DRPs would be caused from lack of consideration for dosage and drug interaction. General Practitioner's prescriptions had more DRPs in Unnecessary Drug (ENT 70.37% vs GP 78.85%), Wrong drug (ENT 4.12% vs GP 9.98%). These DRPs would be associated with drug selection. This study was assumed that Specialized Practitioner is better prescriber than General Practitioner because Specialized Practitioner complete additional intern and residency training. But, Specialized Practitioner is not always better prescriber than General Practitioner. Furthermore, prescriptions of both Specialized Practitioner and General Practitioner had many problems. In conclusion, It could be cut down the excessive medical expense and expected more efficient medical care by reducing DRPs, thus contributing to the improvement of national health. In order to pharmacist must have good professional ability of pharmacotherapy to help the physician for the drug selection.

Organizational Socialization and Intention to Leave in Operating Room Nurses Working at Secondary General University Hospitals (수술실 간호사의 조직사회화와 이직의도)

  • Yoon, Su Jung;Park, Hye-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.1
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    • pp.88-98
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    • 2015
  • Purpose: To evaluate the relationship between organizational socialization and intention to leave, and to identify factors affecting on intention to leave in operating room nurses. Methods: This study used a descriptive design. Seventy operating room nurses recruited from three hospitals under the same management style, in-service educational system, and working conditions agreed to participate in this study, and completed self-administered questionnaires of the organizational socialization and the intention to leave questionnaire. Respondents were classified by career as advanced beginner, competent practitioner, proficient practitioner and expert practitioner by Benner's stages of nursing proficiency. Data were analyzed with t-test, ANOVA with multiple comparisons, Spearman correlation, and multiple regression analysis. Results: Nurses unsatisfied with the current in-service continuous education had lower organizational socialization and higher intention to leave. In advanced beginners, job performance was lowest and organizational commitment was highest. In expert practitioners, intention to leave was highest. Organizational commitment, interpersonal relationship, identity and burnout were associated with intention to leave. Mutual trust, burnout, and interpersonal relationship were predictors of intention to leave explained 20.8% of variance. Conclusion: The career ladder program to enhance nurses' organizational socialization and intention to stay should be established and expanded for well-experienced operating room nurses.

A Study on the Perception of Infection Control in Ultrasound Diagnostic Room (초음파검사실 감염관리 인식에 대한 연구)

  • An, Hyun
    • Journal of radiological science and technology
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    • v.43 no.5
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    • pp.367-374
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    • 2020
  • The purpose of this study is to understand the infection prevention system and infection management perception of Ultrasound diagnostic room in medical institutions by sonographer's in general practitioner, semi and general hospitals. As a research method, a statistical analysis was conducted by surveying a total of 20 items in four category to determine the infection perception of sonographer's according to gender, age, working institution, and working period. As a result of infection awareness, males were in the ultrasound gel management category, women were in the transducer management category, all age groups were in the transducer management system category, and the General Practitioner, semi and general hospitals. were in the transducer management system category, and general hospitals showed a high degree of infection awareness in the category of disinfection and sterilization, and in the category of transducer management in the entire working period. In the results of the analysis of the correlation between the sub-factors of the perception of infection control in the Ultrasound diagnostic room the degree of correlation between each category showed a middle degree correlation(r>0.5) and a significant difference by category(p<.01). In conclusion, the prevention of infection in the ultrasound diagnostic room, which sonographer's firms think, was found to be the most efficient ultrasound diagnostic room infection control to implement transducer and gel management in accordance with the principles of disinfection and sterilization.

Structural Analysis and Practitioner Needs Survey for a WMSD Prevention Program (근골격계질환 예방관리 프로그램에 대한 구조 분석 및 실무자 요구 사항 조사)

  • Jung, Ki-Hyo;Lee, Sang-Ki;Kwon, O-Chae;You, Hee-Cheon;Kim, Dae-Seong
    • Journal of the Ergonomics Society of Korea
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    • v.24 no.3
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    • pp.35-41
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    • 2005
  • The KOSHA codes H-31 and H-30 provide general guidelines to establish a prevention program for work-related musculoskeletal disorders(WMSD). Understanding of the components and practitioner needs for a WMSD prevention program is necessary for effective revision and implementation of the KOSHA codes. The present study established a comprehensive structure for a WMSD prevention program and surveyed practitioner needs for the KOSHA codes. The comprehensive prevention program structure, consisting of 7 parts(organization, education, risk management, medical management, program evaluation, and record keeping) and 90 items, was constructed by analyzing WMSD prevention guidelines published by various government agencies such as KOSHA, OSHA and NIOSH. Next, 20 practitioners, from four industry sectors(auto manufacturing, auto part manufacturing, shipbuilding, and machinery), working in a safety and health department or labor union, were interviewed to collect opinions for the KOSHA codes in terms of relevance, government support, and additional information needed. Guidelines of the KOSHA codes requiring modifications and government supports were identified, which can be used to revise the KOSHA codes and to establish a government policy to promote the implementation of the KOSHA codes. Lastly, the survey revealed that integrated, customized, quantitative, and case information for WMSD prevention is additionally needed, which can be used as design guidelines for a WMSD prevention program manual for practitioners.

Task Analysis of Korean Transplantation Nurse Practitioner (장기이식 전문간호사의 직무분석)

  • 변수자;김희경;김애리;하희선;전경옥
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.179-188
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    • 2003
  • Purpose: This study was designed to create the job description of Korean transplantation nurse practitioner and examine performance frequencies, criticality, and difficulties of task elements. Method: The sample consisted of 63 nurses and coordinators who performed duties related to transplantation at medical center in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviations were conducted to examine the subject's general characteristics, the frequencies, criticality, and difficulties of task performance. Result: The job description of transplantation nurse practitioners revealed 5 duties, 22 tasks, and 85 task elements. On the all five duties, the averages of the performance frequency, criticality, and difficulty were 2.41, 3.38, and 2.78, meaning that the respondents rarely perform the 5 duties, but consider them critical and easy to perform. Conclusion: The job description of the transplantation nurse practitioner included duty, task, and task element and definition of job completed. Thus we recommended a data based trial to confirm and validate the information gathered.

Factors Associated With Long-term Retention in Antiretroviral Therapy Among People Living With HIV: Evidence From a Tertiary Hospital in Jakarta, Indonesia

  • Ifael Yerosias Mauleti;Krishna Adi Wibisana;Djati Prasetio Syamsuridzal;Sri Mulyati;Vivi Lisdawati;Ika Saptarini;Nurhayati;Armedy Ronny Hasugian;Harimat Hendarwan
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.252-259
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    • 2024
  • Objectives: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment. Methods: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years. Results: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72). Conclusions: Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

Geographical Distribution of Physician Manpower under the Influence of Public Health Physician (의사인력의 지역간 분포양상 및 공중보건의사의 영향)

  • 서용덕;차병준;박재용
    • Health Policy and Management
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    • v.3 no.2
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    • pp.81-99
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    • 1993
  • The purpose of this research is to assess the geographical distribution of physicians and dentists and the degree of maldistribution of the physician. Data were obtained form the Korean Medical Association's report on physicians registry and census for 1990. To assess the degree of disparity in the rural-urban distribution of physician manpower and to identify changes in the distribution pattern, the Gini index of concentration was used. Major findings are as follows; 1. Urban-rural disparity in the distribution of physician manpower exists in all categories of manpower, i.e. physician, dentist, oriental medical doctor, general practitioner, medical specialist, practitioner, public health physician and public health dentist. Urban area which had 74.4% of nation's population, accounted for over 90% of all physician manpower. 2. In terms of the ration of physician manpower per 10, 000 population, in urban area, they were 8.2 physicians, 2.7 general practitioners, 5.5 specialists, 3.0 practitioners, 1.8 dentists and 1.3 oriental medical doctors. In rural area, the ratios were 1.4 physicians, 0.6 general practitioners, 0.9 specialists, 1.0 practitioners, 0.4 dentists and 0.4 oriental medical doctors. 3. Gini indicies computed to measure inequality of physician manpower distribution were 0. 3675 for physicians, 0.3372 for general practitioners, 0.3338 for specialists, 0.2263 for practitioners, 0.3132 for dentists and 0.3293 for oriental medical doctors. 4. Inspite of increase in the number of physician manpower, urban concentration of physician manpower intensified from 1980 to 1990. However, the Gini index for all physician manpower fell by 18.3~36.7% from 1980 to 1990, indicating more even distribution. 5. In rural area, the public health physicians and dentists had increased the ratios of physicians, general practitioners, practitioners and dentists per 10, 000 population remarkebly, and had decreased the Gini indicies of physicians, general practitioners, practitioners and dentists. Thus, public health physicians and dentists contributed to improve the distribution of physician manpower in rural area. Based on the results of this study, long-term and rational manpower policies should be developed to solve the problem of geographical maldistribution of physician manpower as well as short-term policy for inducing physicians to the rural areas.

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Professional Self Concept of Psychiatric Mental Health Nurse Practitioner and General Nurse in Psychiatric Ward (정신병동의 정신보건간호사와 일반간호사의 전문직 자아개념)

  • Park Mi Sun;Yang Soo;Yu Sook Ja
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.95-104
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    • 2002
  • Purpose : This study was conducted to investigate the extent to which the professional self concept between the psychiatric mental health nurse practitioner (PMHNP) and general nurse in psychiatric ward was comparable. The results were expected to provide basic data for developing the construct of professional self concept and making awareness of the importance of the program increasing professional self concept. Method : The subjects of this study were 227 PMHNP and 436 general nurse in psychiatric ward. The instruments used for this study were PSCNI by Arthur (1990), PSI by Heppner and Peterson(1982) and the index of work satisfaction by Slavitt et al.(1978). With the aid of the SAS, t-test. two-way ANOVA and stepwise multiple regression were conducted. Result : 1. The average item score of PSCNI of PMHNP was $2.82\pm0.27$. and that of general nurse was $2.66\pm0.27$. Statistically significant difference between two groups was found(p=0.0000) 2. There was statistically significant difference between two groups in the score of professional practice(p=0.0000), satisfaction(p=0.0024), leadersbip(p=0.0000) , flexibility(p=0.0000) and skill (p=0.0000). 3. Statistically significant differences between the two groups were observed in terms of age(p=0.0003), marital status(p=0.0001). education(p=0.0005), religion(p=-.0144), motive (P=-.0001), length of service as a nurse(p=0.0121), the length of service in psychiatric unit(p=0.0143). However there were no significant interaction effect with group and age, marital state. education, religion, motive, length of service as a nurse, length of service in psychiatric unit. 4. Job satisfaction (JS) and problem solving inventory score(PS) were found to be the highest factor predicting the professional self concept between the PMHNP and general nurse. JS and PS accounted for $43.4\%$ in the professional self concept of PMHNP, whereas PS, JS, age and religion accounted for $53\%$ in the professional self concept of general nurse in psychiatric ward. In conclusion, this study suggested that we need to develop programs and polices to increase the professional self concept of nurse, particularly of psychiatric mental health nurse practitioners.

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Characteristics of Prescription Drugs for Acute Upper Respiratory Tract Infection in Outpatient Clinics - Centered on Family Medicine, Internal Medicine, Pediatrics, Otorhinolaryngology and General Practitioner Clinics - (1차 의료기관의 급성 상기도 감염 질환자 의약품 처방특성 - 가정의학과, 내과, 소아청소년과, 이비인후과, 일반의 중심으로 -)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.11 no.3
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    • pp.37-49
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    • 2017
  • Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

Validation of the Korean Version of the General Practitioner Assessment of Cognition (K-GPCog) (한국형 실무자용 노인인지기능 사정도구(K-GPCog)의 신뢰도, 타당도 분석)

  • Park, Jee-Won;Kim, Yong-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.13 no.1
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    • pp.5-12
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    • 2010
  • Purpose: The purpose of this study was to examine the psychometric properties of the Korean version of the General Practitioner Assessment of Cognition (K-GPCog) scale. Method: The K-GPCog consists of the 2 subscales, patients and caregivers. Using a sample of 412 community-based Korean older adults, internal consistency reliability was estimated using Cronbach's alpha. To evaluate validity of the K-GPCog, correlational analysis was conducted using Pearson r between K-GPCog and the Korean Dementia Screening Questionnaire (KDSQ). Results: Cronbach's alpha coefficients of the K-GPCog patients' and caregivers' subscales .788 and .794 respectively. Pearson's correlation coefficients were r=-.374, r=-.481, and r=-.493, respectively for the subscales of patients and primary caregivers, and total K-GPCog. The degree of diagnostic agreement about the risk for cognitive disorders of older adults showed 11.7% and 11.2% respectively for the K-GPCog and the KDSQ. Conclusion: The findings provided preliminary evidence of the K-GPCog as a useful screening measure for detecting mild cognitive disorders of Korean older adults. The K-GPCog is particularly useful to identify cognitive disorders from primary caregivers when it is difficult to assess the level of cognition of older adults.